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Do the benefits of sodium-glucose cotransporter 2 inhibitors exceed the risks in patients with type 1 diabetes?

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Title: Do the benefits of sodium-glucose cotransporter 2 inhibitors exceed the risks in patients with type 1 diabetes?
Authors: Kamoshima, Hikaru Browse this author
Nomoto, Hiroshi Browse this author →KAKEN DB
Yamashita, Kumiko Browse this author
Takahashi, Yuka Browse this author
Tsuchida, Kazuhisa Browse this author
Kuwabara, Saki Browse this author
Miya, Aika Browse this author
Cho, Kyu Yong Browse this author
Kameda, Hiraku Browse this author →KAKEN DB
Nakamura, Akinobu Browse this author →KAKEN DB
Atsumi, Tatsuya Browse this author →KAKEN DB
Taneda, Shinji Browse this author
Kurihara, Yoshio Browse this author
Aoki, Shin Browse this author
Ono, Yuri Browse this author
Miyoshi, Hideaki Browse this author →KAKEN DB
Keywords: Key words
Sodium-glucose cotransporter 2 inhibitor
Type 1 diabetes
Diabetic ketoacidosis
Issue Date: 28-Jan-2022
Publisher: 社団法人 日本内分泌学会 The Japan Endocrine Society
Journal Title: Endocrine journal
Publisher DOI: 10.1507/endocrj.EJ21-0573
Abstract: Sodium-glucose cotransporter 2 inhibitors (SGLT2is) are well-established means of improving glycemia and preventing cardio-renal events in patients with type 2 diabetes. However, their efficacy and safety have yet to be fully characterized in patients with type 1 diabetes (T1D). We studied patients with T1D who regularly attended one of five diabetes centers and treated with an SGLT2i (ipragliflozin or dapagliflozin) for 52 weeks, and the changes in HbA1c, body mass, insulin dose, and laboratory data were retrospectively evaluated and adverse events (AEs) recorded during December 2018 to April 2021. A total of 216 patients with T1D were enrolled during the period. Of these, 42 were excluded owing to short treatment periods and 15 discontinued their SGLT2i. The mean changes in glycated hemoglobin (HbA1c), body mass, and insulin dose were -0.4%, -2.1 kg, and -9.0%, respectively. The change in HbA1c was closely associated with the baseline HbA1c (p < 0.001), but not with the baseline body mass or renal function. The basal and bolus insulin doses decreased by 18.2% and 12.6%, respectively, in participants with a baseline HbA1c <8%. The most frequent AE was genital infection (2.8%), followed by diabetic ketoacidosis (DKA; 1.4%). None of the participants experienced severe hypoglycemic events. In conclusion, the administration of an SGLT2i in addition to intensive insulin treatment in patients with T1D improves glycemic control and body mass, without increasing the incidence of hypoglycemia or DKA.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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